| Name | Theodore Robert Pelletier |
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| Sex | male |
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| Birth Date | December 9, 1931 |
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| Death Date | November 25, 1983 |
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| Age at Death | 51 years, 11 months, 16 days old |
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| Birth Place | California |
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| Death Place | Los Angeles County, California |
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| Mother's Maiden Name | Hammer |
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| Social Security Number | 543-26-3259 |
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